| NPI | 1992146179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: IL 036-144964) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.022448) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2021-07-14 |